Surgical success of lateral rectus resection for residual and recurrent esotropia

Purpose To assess the surgical outcomes of reoperations for residual and recurrent esotropia. Methods A retrospective chart review of all patients who underwent surgery during 2000–2017 at a tertiary referral medical center for recurrent or residual esotropia was conducted. Patients who underwent bilateral medial rectus recession as primary surgery and lateral rectus resection as second surgery were included. The success rate of second surgery and its association to various factors were examined. Success of reoperation was defined as mean deviation of < 10 prism diopters (= PD) at last follow-up. Results Twenty-seven patients with mean post-operative follow-up of 50.4 ± 31.7 months were included. On last follow-up examination, 15 (55.6%) patients had a successful reoperation and 12 (44.4%) patients had unsuccessful reoperation. The two groups were similar in the pre-operative amount of esotropia for distance and near. On last follow-up examination, the amount of mean deviation was 1.9 PD esotropia (8 PD exotropia to 9 PD esotropia) in the success group and 11.2 PD esotropia (22.5 PD exotropia to 35 PD esotropia) in the failure group. In the failure group, 75.0% of patients were under-corrected (esotropia of ≥ 10 PD) on last follow-up examination. Conclusion Strabismus reoperation in cases of residual or recurrent esotropia was successful in slightly more than half of the patients. Surgical failure was more commonly associated with undercorrection and less with overcorrection.